Sacrococcygeal Teratoma Masquerading as Congenital Hemangioma

Abstract

Sacrococcygeal teratoma (SCT) is a rare tumor, present in approximately one in 40,000 live births. A small proportion of SCT have malignant potential, so prompt recognition and surgical resection are necessary. We report two cases of SCT initially misdiagnosed as hemangiomas because of their cutaneous appearance and in particular vascular stains overlying soft tissue mass. These two cases emphasize that SCT should be considered in the differential diagnosis of hemangiomas and in particular of congenital hemangiomas.

Acute enlargement of a vascular plaque and gait changes in a young girl

“…Many SCTs are asymptomatic, but associated clues to diagnosis may include renal or bowel dysfunction, as well as neurological changes 123…”

“…SCTs are the most common germ cell tumours in neonates and infants, with an incidence of approximately 1 in 40 000 live births 12…”

“…High output cardiac failure and fetal hydrops may occur in the fetus, and large SCTs may haemorrhage at the time of delivery 17…”

Congenital sacral mass in a newborn

“…Imaging of a congenital hemangioma shows a high‐flow vascular lesion, which also differentiates it from SCT. In the literature, a sacral teratoma has been clinically misdiagnosed as a congenital hemangioma …”

“…5 The differential diagnosis of a presacral mass in a newborn includes teratomas, myelomeningoceles, lipomas, chordomas, fibromas, and other muscle, bone, and neurogenic tumors. 6 MRI studies may help differentiate between these lesions and can identify any spinal cord involvement. IHs, for which our patient was referred, are usually not fully formed at birth.…”